Provider Demographics
NPI:1184771461
Name:LOWE, JAMES WELLINGTON (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WELLINGTON
Last Name:LOWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1583 S. MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580
Mailing Address - Country:US
Mailing Address - Phone:574-265-6743
Mailing Address - Fax:
Practice Address - Street 1:1020 HIGH ROAD
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:IN
Practice Address - Zip Code:46506
Practice Address - Country:US
Practice Address - Phone:574-546-2211
Practice Address - Fax:574-546-4312
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035648A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01035648AOtherSTATE LICENSE
IN100225240AMedicare ID - Type Unspecified
IN01035648AOtherSTATE LICENSE